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Attachments <br /> Description of Required Attachments <br /> a) Applicant Organization’s Budget and Project Budget <br /> Please complete the provided budget worksheets for your organization and your proposed project or submit your own <br /> budget file (as long as it contains the same information, and in a similar format, as requested in the provided worksheets. <br /> Please explain other in your budget). The Budget Worksheets file is available for download from the County website here . <br /> Please submit the budget in PDF form and in the original editable Excel format. <br /> b) IRS Federal Form 990 or 2023 Tax Returns <br /> A copy of the applicant organization’s most recent Form 990 or IRS Tax Returns is required to determine eligibility. The <br /> specific form depends upon the applicant organization’s financial activity. Review the IRS’ guide , for more details. For Form <br /> 990-N (e-postcard) filers, include a copy of the postcard, with the organization’s application materials. <br /> c) IRS Federal Form 990 or 2023 Tax Returns for collaborator/partner (if they are receiving project funds) <br /> A copy of the collaborator/partner ’s most recent Form 990 or IRS Tax Returns is required to determine eligibility. The specific <br /> form depends upon the organization’s financial activity. Review the IRS’ guide , for more details. For Form 990-N (e-postcard) <br /> filers, include a copy of the postcard, with the organization’s application materials. <br /> d) List of Board of Directors (if applicable) <br /> Provide the following information about each member of the board of directors: name, telephone number, and address. The <br /> list must identify the principal officers of the governing body and the length of term. Please feel free to use the template <br /> provided in Table 2 of the appendix or your own format. <br /> e) Certificate of Liability Insurance <br /> A copy of the applicant organization’s current certificate, from the organization’s insurance carrier. Table 1 below outlines <br /> insurance types and minimums required, for each jurisdiction. If exempt from Worker ’s Compensation compliance, include a <br /> statement explaining why, with the applicant organization’s application materials. <br /> NOTE: Proof of insurance is not required at the time of application submission. If your agency is approved for funding, <br /> documentation of insurance must be provided to the jurisdiction awarding the funding when the contract is awarded. The <br /> insurance certificate should reflect the funding jurisdiction as an additional insured party and certificate holder and provide <br /> coverage for the duration of the funding period (two years, beginning as early as October 1, 2024). If proof of insurance can <br /> only be written for one year, an update will be required for all ongoing projects. Renewal certificates must be sent to the <br /> jurisdiction 30 days prior to any expiration date, cancellation or modification of any stipulated insurance coverage. <br /> NOTE: Upon request, insurance requirements may be reviewed on a case by case basis by the County. Please contact the <br /> staff identified on the Submission Requirements on Page 12 if you have questions or would like to request a review of your <br /> insurance requirements. <br /> Page 27 of 28 <br />Docusign Envelope ID: 257985C7-FC41-4937-8E64-B610C38DBA58